Enterococcus faecium

Enterococcus faecium


General Information

  • Cystitis - Ampicillin (even if resistant due to extremely high urinary concentrations)
  • Complicated infections with confirmed susceptibilities, ampicillin or vancomycin or daptomycin

Gram positive cocci in short chains

Primary driver of VRE colonization is antibiotic exposure - prolonged use of vancomycin and biliary excreted agents with unreliable anti-enterococcal activity (cephalosporins, Fluoroquinolones, metronidazole)

  • Colonization

  • Bacteremia

  • Endocarditis (usually subacute)

  • Intra-abdominal or hepatobiliary infection

  • UTI

More likely to cause true infection in immunocompromised individuals or after selection pressure from antimicrobial administration has eliminated other organisms

A majority of E. faecium will be VRE - refer to antibiogram